McKinze Darlene Goldman

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

BACB791146 Issued in IL

Practice address

1808 N Church St
Belleville, IL 62221-4033

Phone

(618) 975-3692

NPI assigned

Jan 16, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673827200000",
    "number": "1851006670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 N CHURCH ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622214033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 N CHURCH ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622214033",
            "telephone_number": "618-975-3692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "MCKINZE",
        "middle_name": "DARLENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": "BACB791146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "U6231413206",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mgoldman@acornhealth.com",
            "affiliation": "N",
            "address_1": "1808 N Church St",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622214033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrea Noelle Glant, LCSW
• Walter R. Glauber, NP
• Carmon L Glover III, DO
• Antonia M Goelz, P. T.
• Daphne Goewey
• Traci A Goldschmidt
• Mary L Gonzales, CRNA
• Kimberly Goodson
• Debra Gordon, MS CCC SLP
• Joyce Ann Goscinski, PT

• Behavior Technician in Belleville, IL
• Providers in Belleville, IL by specialty
• Behavior Technician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.